The overuse and misuse of antibiotics in Africa is driving a surge in antimicrobial resistance (AMR), threatening public health progress and putting millions of lives at risk, the Africa Centres for Disease Control and Prevention (Africa CDC) warned in a new report.
AMR occurs when microorganisms—such as bacteria, viruses, fungi, and parasites—evolve to resist medications, including antibiotics, antivirals, antifungals, and antiparasitics, that were once effective in treating infections. The Africa CDC’s report stresses the urgent need to strengthen surveillance, laboratory capacity, and data-sharing systems to tackle the growing crisis.
Antibiotics have long been a cornerstone of modern medicine, saving millions of lives. However, their overuse and misuse in healthcare, agriculture, and livestock are accelerating the rise of resistant microorganisms. In 2019, AMR caused an estimated 23.7 deaths per 100,000 people in Africa, surpassing the combined toll of HIV/AIDS, tuberculosis, and malaria. AMR also threatens food security, economies, and livelihoods across the continent, according to the report.
Africa faces numerous challenges in addressing AMR, including weak laboratory systems, limited surveillance, and gaps that allow resistant microorganisms to spread. Poor hygiene, counterfeit antibiotics, and inadequate infection control measures further exacerbate the problem.
Alarmingly, only 16% of the 37 countries surveyed conduct regular AMR checks in animals, even though resistant bacteria have been detected on farms. A study by the Africa CDC’s Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) found that only 1.3% of microbiology labs in 14 member states can test for critical AMR pathogens, exposing a significant lack of diagnostic tools.
A separate study published in The Lancet revealed that only 1% of 53,770 labs in 14 countries have the capacity to test for bacteria, leaving over 136 million people without access to antimicrobial testing. Furthermore, just 23% of labs meet ISO15189 accreditation standards, and automated diagnostic tools are scarce, highlighting the urgent need for investment in National Action Plans (NAPs) to combat AMR.
While private and not-for-profit labs generally perform better than government labs, NAPs allocate less than 20% of their budgets to addressing these critical gaps.
Experts recommend expanding bacterial testing to cover 80% of the population, decentralizing services, improving lab certification, and using electronic data systems with sentinel sites for better monitoring. Strengthening laboratory systems is essential for timely interventions and public health protection.
In response, Africa CDC has launched several initiatives, including the Africa Pathogen Genomics Initiative (PGI), which aims to equip countries with tools for real-time AMR tracking and response. These efforts are designed to enhance laboratory diagnostics, microbiology, and genomic monitoring across the continent. Africa CDC is also running training programs to build a skilled workforce capable of handling research, surveillance, and interventions related to AMR.
The global community has increasingly focused on AMR, with the second High-Level Meeting on AMR during the 79th United Nations General Assembly in September 2024 adopting a political declaration to reduce AMR deaths by 10% by 2030. The declaration, backed by $100 million in funding, includes commitments to ensure better water, sanitation, and hygiene (WASH) in healthcare facilities, comply with WHO infection prevention standards, and reduce antibiotic misuse in farming.
The Jeddah Commitments, introduced at the fourth Global High-Level Ministerial Conference on AMR in Saudi Arabia, stress sustainable funding and equitable access to antimicrobials.
Simple measures, such as improving WASH and infection prevention in healthcare facilities, could prevent up to 20% of AMR-related deaths each year in Africa.
Africa CDC has championed these priorities in its Continental Landmark Report, ensuring African challenges are included in global efforts to combat AMR. These commitments are aimed at strengthening Africa’s capacity to fight AMR and contribute meaningfully to the global response.
Malawi has emerged as a promising example of success in addressing AMR. The country’s Antimicrobial Resistance Coordinating Committee (AMRCC), established within the Ministry of Health, uses a One Health approach to integrate human, animal, and environmental health sectors. Strong laws, political backing, and regular training for health workers have contributed to the committee’s success, along with robust monitoring systems and collaboration with stakeholders.